靶控麻醉输注(TCI)得普利麻加瑞芬太尼诱导对抑制气管插管反应作用观察

Inhibitory Effects of Mixture of Propofol and Remifentanil by TCI on Tracheal Intubation Response

目的探讨在使用术前用药前提下应用靶控输注得普利麻与瑞芬太尼混合液实施快诱导气管插管时的量效分析.方法采用Probit法计算得普利麻、瑞芬太尼ED50和ED95及95%的可信区间,通过转换为mg/kg找到二者混合时最佳剂量.结果应用Probit法计算ED50和ED95,得普利麻分别为0.70mg/kg(95%可信区间为0.63%～0.74%g)、1.03mg/kg(95%可信区间为0.94%～1.19%g).瑞芬太尼分别为1.39μg/kg(95%可信区间为1.27%～1.49%)、2.05μg/kg(95%可信区间为1.88%～2.37%).结论使用咪唑安定、哌替啶、氟哌利多作为术前用药前提下输注得普利麻与瑞芬太尼混合液实施快诱导气管插管能很好地抑制气管插管反应.

Objective To investigate the dose-response relationship of the mixture of propofol and remifentanil by TCI for rapid induction before tracheal intubation under the condition of premedication,and to find the optimal dose of propofol and remifentanil when they are mixed.Methods The adult patients of both sexes,ASAⅠ～Ⅱ,aged 20～60 yr,were enrolled in the study.The patients were premedicated with midazolam,pethidine and droperidol.Anesthesia was rapidly induced with the mixture of propofol and remifentanil at a plasma concentration of 3.0 μg/mL.The BP,HR and intubation response were recorded.The Probit method was used to calculate the ED50 and ED95 of propofol and remifentanil,and the 95% confidence interval.Results The ED50 and ED95 was calculated using Probit method.The ED50 and ED95 of propofol were 0.70 mg/kg（95% confidence interval 0.63～0.74 mg/kg） and 1.03 mg/kg（95% confidence interval 0.94～1.19 mg/kg）,respectively.The ED50 and ED95 of remifentanil were 1.39 μg/kg（95% confidence interval 1.27～1.49 μg/kg） and 2.05 μg/kg（95% confidence interval 1.88～2.37 μg/kg）,respectively.Conclusion The intubation response can be inhibited effectively after rapid induction with the mixture of propofol and remifentanil under the condition of premedication with midazolam,pethidine and droperidol.